RESUMO
Surgical procedures intended for treating obesity and related disorders, known as bariatric surgery or obesity surgery, have been performed for more than 60 years. Although there are several types of interventions, all of them produce sustained weight loss and some improvement in metabolic comorbidities such as type 2 diabetes, dyslipidemia and hypertension. The main mechanisms involved in postsurgical metabolic changes are weight loss mediated-decreased lipotoxicity, decreased caloric intake, and the incretin effect. Current indications for bariatric surgery are being reviewed due to its weight loss independent-benefits and, on the other hand, the limitations of conventional therapies...
Assuntos
Humanos , Cirurgia Bariátrica , Obesidade/cirurgia , Tecido Adiposo/cirurgia , Medição de RiscoRESUMO
Gestational Diabetes is characterized by different degrees of glucose intolerance that produce a series of fetal and perinatal alterations. During many years, in those cases of gestational diabetes that did not respond to nutritional interventions, the use of insulin was a proven treatment to achieve metabolic control and thus a better perinatal outcome. At present, some new oral hypoglycemic drugs, from the family of sulfonylureas and biguanides, have been shown to be safe, of low cost, and apparently effective in the metabolic control of this disease. We review the publications that propose the use of oral hypoglycemic drugs for the metabolic control of gestational diabetes that does not respond to nutritional measures.
Assuntos
Feminino , Humanos , Gravidez , Diabetes Gestacional/tratamento farmacológico , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Administração Oral , Biguanidas/administração & dosagem , /tratamento farmacológico , Diabetes Gestacional/prevenção & controle , Compostos de Sulfonilureia/administração & dosagem , Resultado do TratamentoRESUMO
La Diabetes Mellitus tipo 2 presenta una importante morbilidad y mortalidad y una incidencia está en aumento, que se asocia al aumento observado en la prevalencia de la obesidad. Diversas medidas han sido evaluadas con el fin de retrasar o prevenir su aparición, entre las cuales se incluyen cambios en el estilo de vida, fármacos insulinosensibilizadores, e inhibidores de la absorción de carbohidratos y lípidos, con resultados esperanzadores. En la actualidad, los cambios en el estilo de vida, entendidos en el contexto de un apoyo multidisciplinario al paciente, constituyen la intervención de mayor impacto. Por otro lado, diversas clases de fármacos empleados en estudios de prevención de eventos cardiovasculares han demostrado cierto efecto en retrasar o prevenir la aparición de Diabetes Mellitus tipo 2, lo cual abre un nuevo escenario para los estudios que se desarrollarán en el mediano plazo.